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01-04-2017 | Original Article

Gender differences in clinicopathological features and prognosis of squamous cell carcinoma of the esophagus

Authors: Takeshi Nishino, Takahiro Yoshida, Seiya Inoue, Satoshi Fujiwara, Masakazu Goto, Takuya Minato, Yoshihito Furukita, Yota Yamamoto, Yasuhiro Yuasa, Hiromichi Yamai, Hirokazu Takechi, Hiroaki Toba, Hiromitsu Takizawa, Mitsuteru Yoshida, Junichi Seike, Takanori Miyoshi, Akira Tangoku

Published in: Esophagus | Issue 2/2017

Abstract

Background

Esophageal squamous cell carcinoma (ESCC) is more frequent in male, and female ESCC patients have better prognosis and tend to diagnose at an earlier stage than male. Regarding these female advantages, gender differences of immunological reaction and sex hormone relations were investigated previously. However, the gender differences of clinicopathological features and prognostic factors of ESCC remain well unknown.

Methods

A total of consecutive 170 Japanese patients, including 28 females with ESCC who newly diagnosed and underwent esophagectomy between January 2004 and March 2013 in our institute, were examined. Clinicopathological features and p53 expression, a potent biomarker reflecting chemoresistance and prognosis, were compared. Prognostic factors were analyzed using a multivariate analysis.

Results

The rates of current drinking, flusher, smoking habits, and Brinkman index in female were lower than those in male (p < 0.001). Tumor location, tumor differentiation, T factor, N factor, clinical stage, and contents of initial treatment had no gender differences. Especially, in the population that received neoadjuvant chemotherapy, excellent pathological effectiveness (>Grade2) was seen much more in female significantly (36.1:66.7 %, p = 0.048). Immunohistostaining revealed positive rates of p53 expression were significantly high in male (50.4:30.5 %, p = 0.007). Postoperative complication occurred more frequently in male than female (52.8:28.6 %, p = 0.024). Estimated 5-year disease-specific survivals by Kaplan–Meier method were worse in male than female at rates of 46.2 and 76.7 %, respectively (p = 0.045). Multivariate analysis by Cox’s proportional hazards model showed that female gender (HR: 0.508, p = 0.023) and tumor depth (HR: 0.572, p = 0.018) were independent prognostic factors of ESCC after resection.

Conclusions

Female ESCC showed prefer prognosis to male ESCC. Low p53 imunohistochemical expression in the female ESCC patients might be related with higher sensitivity to neoadjuvant chemotherapy.

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Title: Gender differences in clinicopathological features and prognosis of squamous cell carcinoma of the esophagus
Authors: Takeshi Nishino
Takahiro Yoshida
Seiya Inoue
Satoshi Fujiwara
Masakazu Goto
Takuya Minato
Yoshihito Furukita
Yota Yamamoto
Yasuhiro Yuasa
Hiromichi Yamai
Hirokazu Takechi
Hiroaki Toba
Hiromitsu Takizawa
Mitsuteru Yoshida
Junichi Seike
Takanori Miyoshi
Akira Tangoku
Publication date: 01-04-2017
Publisher: Springer Japan
Published in: Esophagus / Issue 2/2017
Print ISSN: 1612-9059
Electronic ISSN: 1612-9067
DOI: https://doi.org/10.1007/s10388-016-0554-4

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Gender differences in clinicopathological features and prognosis of squamous cell carcinoma of the esophagus

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